Thursday, December 23, 2004

Depression as a Risk Factor for Mortality in Patients With Coronary Heart Disease

Consciouness affects the complete human system

Depression as a Risk Factor for Mortality in Patients With Coronary Heart Disease: A Meta-analysis -- Barth et al. 66 (6): 802 -- Psychosomatic Medicine: "Depressive symptoms increase the risk of mortality in CHD patients. The risk of depressed patients dying in the 2 years after the initial assessment is two times higher than that of nondepressed patients (OR, 2.24; 1.37 3.60). This negative prognostic effect also remains in the long-term (OR, 1.78; 1.12 2.83) and after adjustment for other risk factors (HR [adj], 1.76; 1.27 2.43). The unfavorable impact of depressive disorders was reported for the most part in the form of crude odds ratios. Within the first 6 months, depressive disorders were found to have no significant effect on mortality (OR, 2.07; CI, 0.82 5.26). However, after 2 years, the risk is more than two times higher for CHD patients with clinical depression (OR, 2.61; 1.53 4.47). Only three studies reported adjusted hazard ratios for clinical depression and supported the results of the bivariate models. CONCLUSIONS: Depressive symptoms and clinical depression have an unfavorable impact on mortality in CHD patients. The results are limited by heterogeneity of the results in the primary studies. There is no clear evidence whether self-report or clinical interview is the more precise predictor. Nevertheless, depression has to be considered a relevant risk factor in patients with CHD. "

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